tbuckley/cabot-search huggingface dataset:
Abstract 05: Length of Time in the United States and Cardiometabolic Outcomes Among Foreign and US-Born Black Adults
Authors: Ifedioranma Anikpo, Leah Dodds, Robert A Mesa, Julien Tremblay, Lilliana Vilchez, Tali Elfassy
Journal: Circulation (2023)

Introduction: Among immigrant populations in the United States (US), proxy measures of acculturation such as length of time (LOT) in the US are associated with poor cardiometabolic health. Nevertheless, limited evidence exists among Black immigrants, and the role of nativity has not been fully explored. We aimed to evaluate the association between LOT in the US and cardiometabolic outcomes among US Black adults. Methods: The National Health Interview Survey (NHIS) is an annual representative survey of non-institutionalized US civilians. We combined data from 2016 - 2018 and included all Black adults (N = 10,034). LOT was defined as the number of years participants were reported to have lived in the US. Outcomes of interest were obesity, hypertension, diabetes, and high cholesterol, each defined based on self-report of ever being diagnosed by a medical doctor. We used logistic regression models to determine whether LOT in the US was associated with cardiometabolic health factors overall and by nativity subgroups - US-born non-Hispanic, Hispanic, African-born, and Caribbean/Central American (CA)-born groups. Models were adjusted for age, sex, race, education, marital status, health insurance status, and family income-to-poverty ratio. All analyses accounted for the NHIS complex survey design. Results: Our study population was 81% US-born non-Hispanic, 5% Hispanic (both foreign- and US-born), 6% African-born, and 6% Caribbean/CA-born groups. Among Black adults overall, compared with those born in the US, the odds of obesity were 70% lower (OR: 0.30, 95%CI: 0.22 - 0.41) for the foreign-born individuals with &lt;15 years in the US, and 44% lower (OR: 0.56, 95%CI: 0.46 - 0.70) for those with ≥15 years. In addition, compared with those born in the US, the odds of hypertension were lower by 67% (OR: 0.33, 95%CI: 0.23 - 0.47) for the foreign-born individuals with &lt;15 years, and by 46% (OR: 0.54, 95%CI: 0.43 - 0.68) for those with ≥15 years in the US. In subgroup analyses, Caribbean/CA-born individuals with &lt;15 years in the US had 68% lower odds of obesity (OR: 0.32, 95%CI 0.13 - 0.76) and 66% lower odds of hypertension (OR: 0.36, 95%CI 0.15 - 0.86) compared to those with ≥15 years, but no significant effect was observed among African-born or Hispanic black adults. Conclusion: Among US black adults, shorter LOT in the US was associated with more favorable cardiometabolic health with differential associations by nativity. This heterogeneity suggests a need to examine the implications of acculturation in the context of the specific population of interest.
Abstract P678: On the Relationship of Breast Arterial Calcification With Coronary Artery Calcification: A Pilot Study
Authors: Carlos Iribarren, Malini Chandra, Danny L Sam, Jamal S Rana, Nathan S Wong, Huanjun Ding, Sabee Molloi
Journal: Circulation (2023)

Breast arterial calcification (BAC) detected in mammograms is an emerging risk-enhancing factor for atherosclerotic cardiovascular disease (ASCVD). The predictive value of coronary artery calcification (CAC) for risk of ASCVD above and beyond traditional risk factors is well-established in women. However, there are few studies that have simultaneously evaluated BAC and CAC. The Multiethnic study of breast arterial calcium gradation and cardiovascular disease (MINERVA) cohort, a large, racially and ethnically diverse cohort of postmenopausal women aged 60-69 (n=5,059) was recruited in 2012-15 at Kaiser Permanente of Northern California (KPNC). BAC was assessed using a densitometry method, and presence of BAC was defined as a calcium mass score&gt;0 mg. Searching the electronic health record up to 5 years after baseline, we identified 33 women (39% non-white) who underwent cardiac computed tomography (CT) because of medical indication. BAC was present in 33% (11/33) whereas CAC (Agastston score &gt;0) was present in 61% (20/33). Nine (27%) were BAC and CAC -; 7 (21%) were BAC and CAC+; 4 (12%) were BAC+ and CAC -; and 13 (39%) were BAC - and CAC+. The correlation between log (BAC+1) and log (CAC+1) was 0.45 (p=0.02) in the entire sample (n=33) and was 0.68 (p=0.09) in the 7 women who were BAC and CAC+. The concordance, sensitivity, specificity, PPV, NPV for BAC considering CAC as the gold standard were 0.48, 0.35, 0.69, 0.63 and 0.41, respectively. The unadjusted odds ratio for log (CAC+1)&gt;0 as a function of Log (BAC+1) was 1.21 (95% CI, 0.27-5.38; p=0.80). Although our sample was small, the findings reflect real-world evidence and suggest that BAC and CAC are not entirely overlapping and thus may convey independent predictive information for ASCVD.
Abstract P206: Later Age at Menarche is Associated With Metabolite Signatures for Cardiovascular Diseases: A Metabolome-Wide Association Study of Racially and Ethnically Diverse Women From the Boston Birth Cohort
Authors: Noel T Mueller, Mingyu Zhang, Yingan Chen, Guoying Wang, Xiumei Hong, Xiaobin Wang
Journal: Circulation (2023)

Introduction: Later menarche onset portends lower risk of cardiometabolic outcomes in adults (e.g., obesity, diabetes, hypertension, and myocardial infarction) and in pregnancy (e.g., preterm birth). However, the underlying mechanisms underlying these associations are unclear. Metabolome-wide association studies afford an opportunity to identify mechanistic pathways. Objective: To identify metabolome signatures of age at menarche in a diverse sample of women. Methods: This analysis includes 1301 women from the Boston Birth Cohort who were enrolled 24-72 hrs. after delivery, when we collected maternal plasma sample for metabolome and information on maternal age at menarche (range 7-18y) via a standard questionnaire interview. We used linear regression and restricted cubic splines to examine the association between age at menarche and metabolites. We adjusted for maternal year of birth, place of birth, education, smoking status, Mediterranean diet score, pre-pregnancy BMI, hypertensive disorders, and diabetes. Results: Of the 1301 study women, 63.7% identified as Black and 21.3% as Hispanic. Maternal age at delivery was 28.3y ±6.6y and age at menarche was 12.87y ±1.95y. Of the 389 metabolites we examined, 63 were associated with late menarche (&gt;15y vs. menarche 12-13y; Fig., A ). A 1-yr increment in menarche age was associated with 7 metabolites ( Fig., B ); of these, imidazole propionate and C18:2 SM were (inverse) linear dose-response ( Fig., C ). Other metabolites, including some implicated in cardiovascular disease (e.g., dimethylguanidino valeric acid), showed a threshold effect starting at menarche &gt;14 years (Fig., C). Conclusion: In this racially and ethnically diverse cohort of women from Boston, later age at menarche is associated with many metabolites, including inverse associations with metabolites that have been previously implicated in cardiovascular disease. Our findings help inform mechanistic pathways and that, if replicated, could be targeted for cardiometabolic prediction and prevention.
Abstract P260: The Association of Changes in Area Deprivation Index With Cardiometabolic Risk Factors: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Erika Clarke, Ebenezer K Aryee, Sui Zhang, Perri Carroll, Priya Palta, Kunihiro Matsushita, Josef Coresh, Lisa A Cooper, Lena M Mathews, Chiadi E Ndumele
Journal: Circulation (2023)

Introduction: Higher Area Deprivation Index (ADI) is associated with greater cardiometabolic risk. The impact of changes in ADI on the likelihood of cardiometabolic risk factors is currently unknown. Methods: Among 12,044 White and Black participants at ARIC Visit 1 (1987-89), we examined the association of cross-categories of ADI quartiles at Visit 1 and at the last visit attended up to Visit 4 (1996-98) with cardiometabolic risk factors at the time of the second ADI measurement. Cross-categories were grouped as stable low ADI (remaining in ADI quartile 1 or 2), increasing ADI (moving from ADI quartile 1 or 2 at Visit 1 to quartile 3 or 4 at follow-up), decreasing ADI (moving from ADI quartile 3 or 4 at Visit 1 to quartile 1 or 2 at follow-up) or stable high ADI (remaining in ADI quartile 3 or 4).We assessed the prevalence of hypertension, diabetes, and obesity in each group at the follow-up time point and used logistic regression to evaluate associations of changes in ADI over the 9-year period with the odds of cardiometabolic risk factors. Results: The study population had a mean age of 63 years, with 55% female and 22% Black adults. Persons with decreasing ADI had a lower prevalence of hypertension, diabetes and obesity at follow-up than those with stable high ADI, while those with increasing ADI had a higher prevalence of hypertension and obesity at follow-up than those with stable low ADI (Figure). In regression models adjusted for age and sex, decreasing ADI was linked to lower odds of hypertension, diabetes and obesity compared to stable high ADI (Table), with stronger associations for hypertension among Black adults (p interaction = 0.03). Increasing ADI was linked to modestly increased odds of obesity compared to stable low ADI. Associations were attenuated after adjustment for lifestyle measures, comorbidities and other social determinants. Conclusion: ADI changes are associated with the prevalence of cardiometabolic risk factors. Interventional studies should assess the cardiometabolic impact of targeting the built environment.
Abstract 03: Partnering in Negating Statistics for Black Women: A Women's Community Wellness Initiative
Authors: Timiya S Nolan, Stephanie Ogonuwe, Songzhu Zhao, Amaris Williams, Sarah Addison, Faith Metlock, Jing Zhang, Joshua J Joseph
Journal: Circulation (2023)

Background: Black Americans have the highest rate of mortality from chronic diseases (e.g., cardiovascular disease, cancer, and diabetes) among all non-indigenous races and ethnicities. Higher attainment of ideal cardiovascular health (CVH), as indicated by AHA’s Life’s Simple 7 (LS7; glucose, cholesterol, blood pressure, body mass index, diet, physical activity, smoking), and Life’s Essential 8 metrics (LE8: LS7 + sleep duration) is associated with a lower risk of mortality from chronic disease among all races and ethnicities. About 70% of health outcomes are influenced by social determinants of health (SDoH) and lifestyle behaviors. Unfortunately, Black American women are more likely to be negatively impacted by SDoH and less likely to engage in healthy lifestyle behaviors than their White counterparts. The Partnering in Negating Statistics (P.I.N.S.) for Black Women Initiative began in 2021 to educate, provide access to resources, and partner in science toward promoting health and wellness among Black women. Herein described is the commencement of the P.I.N.S. Initiative through community-based wellness events and community-dwelling Black women’s attainment of LS7 and LE8. Methods: The P.I.N.S. Initiative capitalized on engagement of academic-community-government partnerships to plan and implement community-based wellness events for Black women. Large signature events boasted opportunities to participate in education, screenings (e.g., mammograms, pap smears, and LS7/LE8 screening), and research. In addition to capture of screening data, event feasibility was assessed via a program evaluation at signature events in August 2021 and 2022. Descriptive statistics (quantitative data) and thematic content analysis (qualitative data) were performed. Results: Community-based wellness events boasted high feasibility in the areas of demand and acceptability. Five hundred Black women attended the events, completing a total of 30 mammograms, 24 pap smears, and 418 biometric screenings. Of women with complete LS7 (N = 123) and LE8 (N = 63) data, the median [interquartile range] LS7 and LE8 scores were 8 [7-10] on a 0-14 scale and 63 [54, 73] on a 0-100 scale. From evaluations (N = 111), attendees (20-74 years old) were well educated (66% with a college degree) and mostly un-partnered (57%). Largely, women heard about our event through family, friends, and community partners. Women were very to extremely satisfied with wellness content (82%) and the program overall (85%). Respondents found value in community engagement and reported the need for an annual event. Conclusion: The P.I.N.S. Initiative is a feasible avenue to engage Black women with largely intermediate cardiovascular health in wellness-focused services. This initiative provides a modifiable framework for further research toward identifying interventions to promote ideal CVH and equitable cardiovascular outcomes.
Abstract P452: The Associations Between Potassium Levels, Arterial Stiffness, and Cardiovascular Disease Risk in the Jackson Heart Study
Authors: Ranee Chatterjee, Clemontina A Davenport, Ervin R Fox, Vasan S Ramachandran, Gary F Mitchell
Journal: Circulation (2023)

Background: Low-normal serum potassium (K) and low dietary K intake are more prevalent in Black than White individuals and are potentially modifiable risk factors for cardiovascular disease (CVD), hypertension, and diabetes, conditions that disproportionately affect Black adults. Arterial stiffness predicts the development of CVD. We sought to determine the associations of K measures with arterial stiffness and incident CVD. Methods: We used data from participants of the Jackson Heart Study who were free of CVD at baseline. We used multivariable linear regression to assess the associations of serum K and dietary K intake with two measures of arterial stiffness: peripheral pulse pressure (PP) and carotid-femoral PWV (CFPWV) - the gold standard. Additionally, we analyzed associations of K measures with incident CVD using multivariable Cox proportional hazard models. Results: Of 4467 participants included in our analyses, 1218 had low-normal serum K (K ≤ 4.0 mmol/L) at baseline, and 407 participants had a CVD event over a median of 13.7 years of follow-up. In minimally-adjusted models, there were significant inverse associations of serum K with PP and CFPWV. The association between serum K and CFPWV persisted after multivariable adjustment (Table). In multivariable models with serum K categorized into quintiles, those with serum K &gt; 4.4 mmol/L had significantly lower CFPWV. There were no significant associations between dietary K and outcomes of arterial stiffness. There were no significant associations between either measure of K and incident CVD. Conclusions: In this cohort of Black adults, higher serum K was significantly associated with reduced arterial stiffness.
Abstract P204: Associations Between Dairy Intake and Serum Metabolites in Middle-Aged Adults in the U.S.
Authors: Lauren Bernard, Jingsha Chen, Hyunju Kim, Zhijie Huang, Lydia A Bazzano, Lu Qi, Jiang He, Varun Rao, Tanika N Kelly, Kaitlin Potts, Kari Wong, Lyn Steffen, Bing Yu, Eugene P Rhee, Casey M Rebholz
Journal: Circulation (2023)

Introduction: There is a lack of objective biomarkers of dietary intake. Untargeted studies can unbiasedly identify dairy biomarkers and inform the creation of robust dietary assessment tools that integrate questionnaire and biospecimen data. Methods: Dairy products from interviewer-administered questionnaires were categorized as either low-fat or high-fat dairy. Total dairy was a composite of low-fat and high-fat dairy items. Linear regression models were used to assess associations between dairy intake and 360 serum metabolites in the Atherosclerosis Risk in Communities (ARIC) Study (n=3907). Significant associations were then tested for replication in the Bogalusa Heart Study (BHS) (n=819). Results: In the ARIC study, 34 dairy-metabolite associations were identified (total dairy, n = 16; low-fat dairy, n = 10; high-fat dairy, n = 8). Total dairy shared 7 metabolic associations each with low-fat dairy and high-fat dairy. Low-fat dairy was associated with pantothenate, vitamin B5, and the catabolic product of vitamin B6, pyridoxate. High-fat dairy was associated with one amino acid, 3-hydroxy-2-ethylpropionate, and eight lipid metabolites, including myristate (14:0), 10-nonadecenoate (19:1n9), and myristoleate (14:1n5). Of the metabolites available for replication in BHS (total dairy, n = 15; low-fat dairy, n = 9; high-fat dairy, n = 8), 2 total dairy metabolites were replicated and 2 low-fat dairy metabolites were replicated ( Table ). Conclusions: We identified metabolomic markers of total, low-fat, and high-fat dairy. Pantothenate, myristate (14:0), and tiglyl carnitine replicated across two large, diverse study populations, suggesting that they are markers of dairy consumption.
Abstract P572: Racial and Ethnic Disparities in Healthcare Access and Utilization Among People With Diabetes in the US
Authors: Thomas Hinneh, Faith Metlock, Oluwabunmi V Ogungbe, Abeer Alharthi, Cheryl R Dennison Himmelfarb, Yvonne Commodore-Mensah
Journal: Circulation (2023)

Introduction: Despite advances in diabetes care, racial disparities in diabetes care and outcomes remain. Moreover, better access to and utilization of healthcare is associated with optimal diabetes control. Yet, little is known about race and ethnicity disparities in diabetes care utilization in the US. Objective: To estimate racial/ethnic differences in access and utilization of health services among adults diagnosed with diabetes in the US population. Methods: In this cross-sectional analyses, we identified and analysed data of 3,563 adults diagnosed with diabetes from the National Health and Nutrition Examination Survey, 2011-2018. The sample (Whites N=1,100, Black N=1,002, Asian N=438, Hispanic N=1,023) included adults ≥18 years who had self-reported diagnosed diabetes. The exposure variable was race/ethnicity groups. Healthcare care access was defined as having a routine place of healthcare, health insurance, and provider for diabetes care; and utilization measures were defined as having checked HbA1c and received diabetes care ≥4 times in the past year. We fitted generalized linear models with Poisson distribution to examine disparities in healthcare access and utilization by race/ethnicity among adults with diabetes. Results: Participants had a mean age of 59 (SE .32) years old, 49% female. In the fully adjusted models, compared to White adults, Hispanic adults were less likely to have health insurance (adjusted Odds Ratio [aOR]: 0.96; 95% CI 0.91-0.99) and less likely to have their HbA1c checked in the past year (aOR: 0.92; 95% CI: 0.86-0.98) ( Table ). There were no significant differences in having a routine place for healthcare, provider for diabetes care, and diabetes care received (≥4 times) in the past year in the fully adjusted analyses. Conclusion: Racial differences exist with lower access and utilization of diabetes care particularly among Hispanic adults. Targeted health interventions to address access to diabetes care are needed.
Abstract P251: Using Art to Mitigate Psychosocial Stress and Blood Pressure Among Black Women: A Pilot Trial
Authors: Anika L Hines, Allison Weiderhold, Sarah Collins, LaPrincess C Brewer, Jessica Larose, Lisa A Cooper
Journal: Circulation (2023)

Background: Black women demonstrate higher levels of stress over the life course compared to Black men, White men, and White women, which may help to explain their higher cardiovascular disease (CVD) morbidity and mortality. Despite implications for primary and secondary CVD prevention and racial disparities, few interventions have targeted psychosocial stress to improve blood pressure (BP) levels among Black women. Objective: To test whether a theory-driven, culturally tailored, community intervention focused on the stress experiences of Black women improves psychological outcomes and BP levels. Methods: The “Art for Hearts” pilot trial sought to examine the feasibility, acceptability, and preliminary efficacy of a novel intervention encouraging creative self-expression. This individual level, single-arm pilot trial recruited self-identified Black women ≥18 years. Women participated in an 8-week program, including 4 art sessions with a community artist (a self-identified Black woman) accompanied by a moderated focus group discussion and 4 heart health education sessions (facilitated by a Black woman researcher) on home BP monitoring, stress management techniques, diet/physical activity, and patient-clinician communication. All sessions were conducted in-person in a community space. Participants completed a survey including self-rated stress (scale of 0 to 7), perceived stress (PSS-10), depressive symptoms (PHQ-8), and anxiety symptoms (GAD-7) at baseline and 8 weeks. BP was measured by a trained assessor at baseline and 8 weeks as well as before and after each session. We examined within-participant changes in psychological measures as well as mean systolic and diastolic BP from baseline to 8 weeks. Results: The study included 18 Black women with a mean age of 44.1 (SD=15.4) years. Women were highly educated (36.8% with a graduate/professional degree) and 11.1% earned an income of ≥$100,000. Mean systolic BP was 114 mmHg and mean diastolic BP was 66 mmHg at baseline. From baseline to 8 weeks, self-rated stress level decreased by 1-point (from 4.36 to 3.18; p=0.005) (scale range: 0 -7). Perceived stress (-1.08; p=0.58) and anxiety (-1.33; p=0.09) decreased from baseline to 8 weeks; however, these changes did not achieve statistical significance. Depressive symptoms significantly improved from baseline to 8 weeks (19.13 to 13.38; p=0.044). There were no differences in systolic or diastolic BP from baseline to follow-up. The intervention was deemed feasible and acceptable with an attendance rate of &gt;80%; participants expressed high overall satisfaction with the intervention. Conclusion: A tailored 8-week pilot intervention using painting self-expression demonstrated feasibility, acceptability, and preliminary efficacy for improving self-rated stress and depressive symptoms. No effects were demonstrated on BP in this sample.
Abstract P328: Higher Intake of Dietary Cholesterol Was Associated With Increased Risk of Myocardial Infarction in the Million Veteran Program
Authors: Shamlan Sheikh, Xuan-Mai Nguyen, Yanping Li, Kerry L Ivey, John M Gaziano, Luc Djousse
Journal: Circulation (2023)

Background: Association of dietary cholesterol with coronary artery disease (CAD) remains inconsistent. We examined the relation of dietary cholesterol with incidence of myocardial infarction (MI), among participants of the Million Veteran Program (MVP). Methods: The MVP is a nationally representative, prospective cohort study of Veterans which started in 2011 and by 2020 had over 800,000 enrollees and looked at factors, that could be associated to their chronic conditions. Dietary intake was one of these characteristics and was collected by self-reported semi-quantitative food frequency questionnaire. MI cases were identified by Surrogate-Assisted Feature Extraction (SAFE) method which is an algorithm approach combing ICD codes, natural language processing and medical record review labels. All information regarding MI were reviewed by combining the VA Corporate Data Warehouse (VDW), which consist of VA EHR and Medicaid/Medicare database, and National Death index databases. Results: Among the 180,156 Veterans with data on dietary cholesterol, mean age was 62 years, 90% men, and 80% White. Mean follow up was 3.5 years. We observed a linear, dose-response, association between dietary cholesterol intake and the risk of MI ( P for linear trend =0.003) (Figure 1). When adjusting for age and sex every increase of 100 mg/day of dietary cholesterol was associated with a 9% higher risk of MI (RR: 1.07, 95%CI: 1.06-1.12). Participants with a cholesterol intake ≥300 mg/day had a 15% higher risk of MI compared to participants whose cholesterol intake was no more than 300 mg/day (RR: 1.15, 95%CI: 1.06-1.25). Conclusion: In our study, increased intakes of dietary cholesterol were associated with a higher risk of MI among US Veterans.